Written Answers Nos. 222-229
222. Deputy Jerry Buttimer asked the Minister for Health if he will provide an update on the implementation plan for the national neuro-rehabilitation policy; the availability of specialist neuro-rehabilitation services; and if he will make a statement on the matter. [28560/13]
View answerThe aim of neuro-rehabilitation is to enable the person to achieve the highest possible level of independence. Desired outcomes range from a return to full independence in social and work situations to a person requiring long-term support and care but with a higher level of independence than in the absence of neuro-rehabilitation. Current services available include acute hospital services; the National Rehabilitation Hospital; multidisciplinary community services; long-term assisted living supports; and rehabilitative training services. These services are provided directly by the Health Service Executive (HSE) and several non-statutory organisations.
The Department of Health and the Health Service Executive (HSE) have developed and published the “National Policy and Strategy for the provision of Neuro-Rehabilitation Services in Ireland 2011 - 2015”. In addition, the HSE is developing its Rehabilitation Medicine Programme within the Clinical Strategy and Programmes Directorate. The Report is the overarching policy on neuro-rehabilitation services and includes proposals for a framework for the future of neuro-rehabilitation services in Ireland, including key elements such as guiding principles; implementation structure; methodology for implementation; and information and communication.
The Report recognises that given the current economic climate, the focus in the short to medium term has to be on re-configuration of services, structures and resources and the enhancement of the skills and competencies required to meet the changing context. The key priority areas, as identified in the HSE’s National Operational Plan for 2013 are to map and develop Integrated Service Area level rehabilitation networks; implement the model of care for rehabilitation services within the networks with a focus on community rehabilitation.
The Rehabilitation Medicine Programme has been working in collaboration with the HSE's National Disability Unit as part of an expert Working Group planning for the implementation of the Report. The Rehabilitation Medicine Programme has incorporated key elements of the Report into its own Model of Care and adopted the Strategy’s recommendation of “hub and spoke” model for specialist rehabilitation services and is keen to progress with a comprehensive model for the continuation of such service into the community. This co-operation will continue in 2013.
224. Deputy Róisín Shortall asked the Minister for Health the position on generic substitution when the least expensive substitute medicine is unavailable to a particular pharmacist; and if he will clarify in these circumstances if a top-up fee will apply to medical card holders in respect of the more expensive substitute medicines available to the pharmacist. [28570/13]
View answerIt is a matter for each pharmacy to determine what medicines it holds in stock. Currently if a patient has a prescription specifying a branded medicine, they will receive that branded medicine from the pharmacist. If a pharmacy does not have a particular medicine in stock the patient may request the pharmacy to order the medicine or alternatively seek the medicine in question from another pharmacy.
The provisions of the Health (Pricing and Supply of Medical Goods) Act 2013 relating to the substitution of interchangeable medicines and reference pricing are expected to be commenced shortly. The Act enables patients to opt for lower cost interchangeable medicines. In general terms, when a pharmacist is presented with a prescription for an interchangeable medicine, which is not the subject of a clinical exemption, the pharmacist is obliged to offer the patient the opportunity to agree to substituting the prescribed product with an interchangeable medicine which is in stock in the pharmacy and is of lower cost to the patient or the HSE, as the case may be. The patient may either accept the interchangeable medicine offered by the pharmacist or opt to receive the branded interchangeable medicine where prescribed. Alternatively, the patient may opt to go to a different pharmacy to receive a less expensive interchangeable medicine.
The Act also allows the HSE to set a reference price for groups of interchangeable medicines. Medical card holders will only face an additional charge where a reference price has been set for a group of interchangeable medicines and the medicine dispensed is priced higher than the reference price and is not the subject of a clinical exemption. It is expected that all pharmacies supplying items to patients under the GMS and community drugs schemes will have products available at or lower than the reference price and therefore patients will not incur any unavoidable costs under this legislation.
Under the Act, when the HSE sets a reference price for a group of interchangeable medicines, pharmacists must be given four weeks' notice before the reference price takes effect. If a pharmacy does not have a medicine available at or below the reference price the patient may request the pharmacy to order a suitable medicine or alternatively seek a lower cost medicine from another pharmacy.
225. Deputy Róisín Shortall asked the Minister for Health the number of asthma related admissions to hospital emergency departments in each of the past five years. [28573/13]
View answer226. Deputy Róisín Shortall asked the Minister for Health the cost of asthma related admissions to hospital in each of the past five years. [28574/13]
View answerI propose to take Questions Nos. 225 and 226 together.
In relation to the particular queries raised by the Deputy, as these are service issues, I have asked the Health Service Executive to respond directly to the Deputy in these matters.
227. Deputy Bernard J. Durkan asked the Minister for Health when chiropathy services will be restored to the day-care centre at St. Brigid’s Nursing Home, Crooksling, County Dublin; and if he will make a statement on the matter. [28613/13]
View answer228. Deputy Bernard J. Durkan asked the Minister for Health the extent to which a full evaluation of the potential at St. Brigid’s Nursing Home, Crooksling, County Dublin, has been carried out with a view to maximisation of scale and extent of services there, including the utilisation of all existing buildings, with the objective of achieving economies of scale in line with best practice and the provision of the widest possible extent of services for a maximum of 120 patients, as previously provided at the hospital; and if he will make a statement on the matter. [28614/13]
View answer229. Deputy Bernard J. Durkan asked the Minister for Health his preferred options for the further and future development and extension of services at St. Brigid’s Hospital, Crooksling, County Dublin; and if he will make a statement on the matter. [28615/13]
View answerI propose to take Questions Nos. 227 to 229, inclusive, together.
As these are service matters they have been referred to the Health Service Executive for direct reply.
